Protective effect of shenfu injection on intestinal mucosa during shock /resuscitation

Zhongyuan XIA; Zhigang LIU; Yuhong HE; Xiangdong CHEN

ABSTRACT

BACKGROUND:

Reperfusion injury and inadequate perfusion exist,causing the injury of intestinal mucosa during shock / resuscitation.

OBJECTIVE:

To investigate protective effect of shenfu injection (SFI) in equal dosage for human effect on intestinal mucosal pH (PHi) of sigmoid colon, the contents of nitric oxide (NO), malonialdehyde(MDA) and Ca2+ of intestinal mucosa, activity of serum diamine oxidase(DAO of rabbits during shock/resuscitation.

DESIGN:

A randomized controlled trial with experimental animals as the subjects.

SETTING:

DepartmentofAnesthesiology, Renmin Hospital of Wuhan University MATERIALS The experiment was performed in the Research Institute of Anesthesiology, Renmin Hospital of Wuhan University from August to October in 2003. Twenty-four adult healthy white rabbits were randomly divided into 3 groups with 8 animals for each Shenfu injection group (SFI group), shock/resuscitation group and control group .

INTERVENTIONS:

Hemorrhagic shock was induced by blood withdrawal from femoral artery at a rate of 2 mL/kg per minute until MAP dropped to 40 mmHg. MAP was maintained at this level for 60 minutes,then the collected auto-blood and the same volume of balanced salt solution was transfused to the animal for preparing shock/resuscitation model. In SFI group the animals were given 2.1 mL/kg SFI together with the auto-blood transfusion and followed by a continuous infusion of 5mL/kg SFI per hour.MAIN OUTCOME

MEASURES:

Intestinal mucosal pH (PHi) of sigmoid colon, NO, MDA and Ca2+ contents of intestinal mucosa, activity of serum DAO were detected before shock (So), 1 hour after shock (S1), 1 hour (R1) and 3 hour (R3) following resuscitation.the R1 reperfusion (7.171±0.102) , and R3 reperfusion (7.194±0.106) of the SFI group were higher than those of the shock/ resuscitation group (6.920±0.155,6.971±0.165,P ＜ 0.05,P ＜ 0.01) and those of the contents of the reperfusion R1 (35.090±1.184) μkat/L and R3 (32.440±2.884) μkat/L of the SFI groups were significantly higher than those of the shock/resuscitation group [(50.994±2.684),(52.377±1.217) μkat/L,P＜ 0.01] and of the control group [(15.970±1.734), (16.620±0.767)μkat/L,Pgroup were significantly lower than those in the shock/resuscitation group [ (61.8±5.3,72.2±5.8 ) μmol/g , (68.2±4.9,96.9±8.5) μmol/L ,P＜ 0.05]. Ca2+ content of intestinal mucosa at reperfusion 3 hours in the SFI group [(2.43±0.27)μmol/L] was lower than that in the shock/resuscitation group [(2.93±0.34)μmol/L,P ＜ 0.05] and higher than that in the control group [(2.26±0.31 )μmol/L, (P ＜ 0.05)].

CONCLUSION:

SFI in equal dosage for human effect could protect intestinal mucosa from shock/resuscitation injury through improving perfusion and oxygenation, inhibit the activity of NO, reduce oxygen free radical and calcium overload, with a good protective effect on intestinal mucosa during shock/resuscitation.